Nicole O'Connor, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN255203 Issued in GA

Practice address

12020 Etris Rd Ste B110
Roswell, GA 30075-8010

Phone

(706) 692-9768

NPI assigned

Oct 27, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Internal Medicine Associates of Jasper, PC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1225109838
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1669199865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 ETRIS RD STE B110",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300758010",
            "telephone_number": "706-929-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 ETRIS RD STE B110",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300758010",
            "telephone_number": "706-692-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN255203",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN255203",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nuture of Thrive LLC
• Michael Osita Nwaneri, MBBS, MD, MSC, MBA
• Chinwe Nwizugbo
• Ronjonette Nacole O'Bannon, LCSW
• Valorie O'Brien
• Connor Jared O'Daniels, PHARMD
• Amy O'Dell, M.ED, LPC, TRS, CNC
• Daniella O'Garro, LAPC
• Adrian Cheria O'Neal, D.M.D.
• Gwendolyn Patricia O'Neal

• Family Nurse Practitioner in Roswell, GA
• Providers in Roswell, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.